title: Short-term and long-term vital outcomes of cirrhotic patients admitted to an intensive care unit.
abstract: OBJECTIVE
  To evaluate short-term and long-term vital outcomes of cirrhotic patients admitted to a general ICU, to evaluate the prognostic value of severity scores and to identify risk factors associated with death.
  
  
  METHODS
  Observational retrospective single-center epidemiological study. All cirrhotic patients admitted to the ICU were eligible for the study. Clinical data, general ICU severity scores, and liver-specific severity scores were recorded. The mortality rate was analyzed during the stay in ICU, at day 28 and month 6 after admission. Risk factors for death were identified by univariate and multivariate analyses.
  
  
  RESULTS
  During the study period, 86 cirrhotic patients were admitted to the ICU. The in-ICU, day-28 and month-6 mortality rates were 37, 48, and 60%, respectively. In the multivariate analysis, mechanical ventilation, the prothrombin time, and the plasma albumin level on admission were associated with the in-ICU mortality, whereas only the plasma albumin level was associated with the 6-month mortality [odds ratio 0.80; 95% confidence interval (0.70-0.92)]. The Sequential Organ Failure Assessment score was more predictive than liver-specific scores for mortality in the ICU, but not at day 28 or month 6.
  
  
  CONCLUSIONS
  ICU admission should not be ruled out for patients with complicated cirrhosis. Although common in cirrhotic patients, low plasma albumin level was the only factor independently associated with short-term and long-term mortalities.
authors.affiliation: Medical Intensive Care Unit, CHU Poitiers, Poitiers Cedex, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Filloux
authors.forename: Carine
authors.initials: C
authors.lastname: Chagneau-Derrode
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Ragot
authors.forename: Julien
authors.initials: J
authors.lastname: Voultoury
authors.forename: Michel
authors.initials: M
authors.lastname: Beauchant
authors.forename: Christine
authors.initials: C
authors.lastname: Silvain
authors.forename: René
authors.initials: R
authors.lastname: Robert
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D005260:Female; D005602:France; D006305:Health Status Indicators; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008103:Liver Cirrhosis / Q000097:blood / Q000401:mortality / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010343:Patient Admission; D011237:Predictive Value of Tests; D011379:Prognosis; D011517:Prothrombin Time; D012372:ROC Curve; D012121:Respiration, Artificial; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D015415:Biomarkers; D012709:Serum Albumin